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Ambulance offload times improving but long-term fix requires systemwide throughput changes, DC Health says
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Summary
DC Health and DC Fire & EMS told the Committee that ambulance offload times (APOT) have improved from over two hours (ninetieth percentile) in January 2023 to about 67 minutes in January 2025, but improvements require systemwide coordination including inpatient throughput and discharge capacity.
The committee pressed DC Health and health-system leadership on efforts to reduce ambulance offload wait times at hospital emergency departments, a concern raised by the firefighters union and community members.
Performance metrics and progress: Senior deputy Sam Hurley explained the city standardized metrics for offload time and set a goal of 30 minutes by October 2026. "In January of 2023 we were over 2 hours as the APOT time for the ninetieth percentile... Now we are down as of January of this year to an hour and 7 minutes," Hurley said, highlighting a significant downward trend.
Why it matters: Committee members noted ambulance availability is a public-safety concern — ambulances tied up at hospitals reduce system capacity for 911 response. Agency leaders said causes are multifactorial: emergency department triage and throughput, delays moving patients from ED to inpatient floors, inpatient discharge processes and lack of step-down or post-acute beds.
Coordination and remedies: DC Health described a cross-sector effort with hospitals, DC Hospital Association and DC Fire & EMS to standardize metrics, deliver hospital-level alerts when ambulances remain in bays too long and convene ED leaders biweekly to share best practices. The agency said system changes take time and acknowledged progress is slower than hoped, but that hospitals and EMS have agreed to the October 2026 timeline to reach the 30-minute target.
Regulatory limits and next steps: Bennett and Hurley told the council the agency lacks a simple regulatory infraction tied solely to offload times; enforcement would need a regulatory framework that addresses systemic bottlenecks rather than only penalizing individual hospitals for delays beyond their control.
Ending: DC Health said it will continue to monitor trends, which show steady improvement from January 2023 levels, and continue convening stakeholders to address inpatient throughput and discharges as central levers to reduce ambulance wait times.
